Psoriasis vs. Eczema: Understanding Key Differences

Psoriasis vs. Eczema

Have you ever been annoyed by itchy patches on your skin? You might have psoriasis, eczema, or a fungal skin infection.

These skin conditions can cause itching, redness, and rashes, and can get worse if not treated.

Psoriasis and eczema are two common skin issues that can be very uncomfortable and often look alike.

Even though they share some symptoms, psoriasis and eczema are actually different from each other.

What is Psoriasis?

This is an autoimmune state that changes the way normal life cycles of skin cells occur. Cells within healthy skin grow deep inside the layers and then slowly rise to the surface while old cells shed to make space for newer ones [ref].

So, this process takes about a month however in psoriasis this cycle goes into overdrive and cells start multiplying up to 10 times faster.

Since this cycle is going at a faster pace it results in the formation of piles of old cells on the surface. This leaves thick red and scaly patches called psoriasis plaques.

They can appear anywhere on the body but mostly on the elbows, knees, scalp, and lower back.

While we are unaware of what causes psoriasis it is believed that environmental factors can play a huge role.

What is Eczema?

This is also called atopic dermatitis and is an inflammatory skin condition that also causes allergy.

Unlike psoriasis, this is not an autoimmune condition attacking healthy cells.

Instead, eczema impairs the natural skin barrier which makes it more susceptible to irritants and allergens in the environment [ref]. It leads to dry, itchy, and swollen patches on the body.

Eczema can look different, sometimes showing small bumps or even oozing fluid in bad cases.

Kids usually get eczema on their face, hands, and inner elbows, while adults might have it on their hands, feet, and eyelids.

Things that can make eczema worse include allergens (like dust mites or pollen), irritants (like strong soaps or wool), and dry weather.

Like psoriasis, eczema does not spread from person to person but can be common in families with a history of allergies.


Psoriasis Vs Eczema Symptoms




CauseAutoimmune disease (overactive immune system)Allergic component (disrupted skin barrier)
Symptoms (main)Thick, red, scaly plaquesDry, itchy, inflamed patches of skin
Location (common)Elbows, knees, scalp, lower back, nails, genitals (less common)Face, hands, inner elbows (children), hands, feet, eyelids (adults)
ScalesSilvery white, prominentLess prominent, finer scaling (if present)
BlistersRareMay develop small blisters, weeping in severe cases
ItchingMild to moderate burning sensation is possibleIntense, often worse at night
Flare-up patternsCyclical, with periods of remission and flare-upsMore variable, triggered by specific allergens or irritants
Skin bleedingPossible, especially if scratched excessivelyLess common
Koebner phenomenonNew plaques develop at sites of injury/irritationNot a feature

Psoriasis Vs Eczema Diagnosis:

psoriasis vs eczema
Characteristic psoriatic plaques on the anterior abdominal wall. Patches of red, inflamed skin with thick, silvery scales are visible

Diagnosing psoriasis and eczema typically involves a combination of factors, but there’s no single definitive test.

Here’s a breakdown of the diagnostic tests for each:

Psoriasis Diagnosis:

  • Medical history: 

Your doctor will ask about your own and your family’s medical history to understand your risk for psoriasis. They will want to know if anyone in your family has autoimmune diseases.

  • Physical examination:

A skin doctor will carefully check your skin, scalp, and nails for signs of psoriasis. They look for thick, red patches with silvery scales. The location of these patches can help, too. They often show up on elbows, knees, scalp, and lower back. [ref].

  • Biopsy (optional):

Sometimes, the doctor might take a small piece of your skin to look at under a microscope. This helps confirm the diagnosis, especially if your symptoms are unusual.

Eczema Diagnosis:

  • Physical examination:

A skin doctor will look at your skin closely for signs of eczema. They will check for dry, itchy, and red areas.

In young kids, these patches often show up on the face, hands, and inner elbows, which can be a sign of eczema.

  • Allergy testing (optional):

If your doctor thinks allergies might be causing your eczema, they might suggest allergy tests to find out what you are allergic to.

  • Patch testing (optional):

This test helps find things that might be causing your eczema to get worse. Different substances are put on small patches on your back, and the reactions are watched for a few days.


Psoriasis Vs Eczema Treatment

Both conditions can be treated based on their underlying causes and symptoms.

Here is a breakdown:

Treatment of Eczema (Atopic Dermatitis):

Eczema treatment focuses on managing symptoms like dryness and inflammation.

The first line of defense is usually a good skincare routine with fragrance-free moisturizers and emollients to strengthen the skin barrier and prevent dryness.

Doctors may prescribe topical corticosteroids, which reduce inflammation and itching during flare-ups.

In severe cases, they might recommend immunomodulatory medications (calcineurin inhibitors) or phototherapy (controlled exposure to ultraviolet light) to suppress the immune system’s overreaction.

Since eczema can be triggered by allergens and irritants, identifying and avoiding those triggers is crucial for long-term management [ref].

Treatment of Psoriasis:

Treatment includes slowing down the rapid skin cell turnover and reducing inflammation.

Moisturizers are essential to maintain skin health just like in eczema and topical corticosteroids are also used for mild to moderate psoriasis.

However, doctors might prescribe stronger medications like calcipotriol (vitamin D derivative) or tazarotene (retinoid) for better control.

For moderate to severe psoriasis, systemic medications like methotrexate or cyclosporine that target the entire immune system may be necessary.

Another good treatment option is using biological drugs as they target specific proteins that cause inflammation.

Unlike eczema, identifying triggers plays a less prominent role in psoriasis treatment, although stress management can be helpful for some patients.


In Conclusion:

Psoriasis and eczema are two common skin conditions with similar symptoms. Identifying the two conditions is important as treatments and long-term prognoses are different.

The table below summarizes the key differences between psoriasis and eczema:




AppearanceThick, red patches with silvery scalesRed, inflamed, and itchy rashes
Common LocationsElbows, knees, scalp, lower backInside elbows, behind knees, neck, wrists
ItchinessMild to severe itchingIntense itching, especially at night
TriggersStress, skin injury, infections, cold weatherAllergens, irritants, stress, temperature changes
Skin TextureDry, raised, and roughDry, cracked, or leathery
Age of OnsetCan develop at any age, commonly 15-35Usually begins in childhood
Associated SymptomsJoint pain (psoriatic arthritis)Asthma, hay fever
TreatmentTopical treatments, phototherapy, systemic medicationsMoisturizers, corticosteroids, immunomodulators
ChronicityChronic, long-lastingCan be chronic but also may resolve over time
Family HistoryOften a family history of psoriasisOften a family history of eczema, asthma, or allergies

What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

I love my family, my profession, my blog, nature, hiking, and simple life. Read more about me, my family, and my qualifications

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